When Will Pharmaceutical Companies Embrace Behavioral Retargeting to Drive Adherence?

Shopping KeyPicture this: You visit a website, add something to your shopping cart, but abandon the transaction. Maybe you are distracted or decide to shop around to get the best deal.

The next day, you’re on a different website. Suddenly an ad pops up on your screen…for that item you had in the shopping cart the day before. In your mind you’re thinking, “Wow, maybe this ad is an omen that I should buy that item?”

You’ll be relieved to learn that the ad is not an omen. It’s just “behavioral retargeting,” one of the tools that a smart marketer is leveraging to capture your attention. They want you back at their site to complete the purchase.

Digital channels can leverage relevancy (based on action and exposure) to deliver highly motivating advertising. If it works well for consumer products, how would this work for pharmaceutical brands?

The Web as a Research Tool
The Internet is used by consumers to compare prices and features. What we find online often influences both online and offline purchasing decisions. In the early days of the Internet, consumers were leery of making significant purchases online and would compare prices on the web then go to a brick-and-mortar store to make their purchase. With improved mobile technology, consumers now see and touch products in stores, only to make the purchase online. Many consumers are now willing to make major purchases online.

The prescription drug buying process is different. Some consumers see advertising for lifestyle drugs on TV and in print, go online for additional information, and ask their doctor for a prescription. If their doctor agrees, they may receive a prescription. A pharmaceutical website for a prescription drug may play a role in initial patient-doctor discussion, but it can really play a much more significant role in influencing medication adherence.

Behavioral Retargeting to Influence Good Behavior
We see many prescription drugs with elaborate, multichannel medication adherence programs that often have minimal impact on the bottom line. The reasons for this are twofold.

  1. Programs that are dependent on patients signing up tend to have very limited reach against the patient base.
  2. They often attract patients who are adherent, so there is little opportunity to increase sales. We also see programs where enrollment is driven by activating a savings card—but too often patients are unaware they joined the program and don’t engage with the communications they receive.

What if we used behavioral retargeting to increase awareness of compliance programs? Imagine if retargeting didn’t just apply to shoes and baby clothes, but also encouraged medication adherence.

Behavioral retargeting provides the ability to extend reach and deliver highly relevant adherence messages contextually, then bring consumers back to your site for deeper content. It provides an additional channel to get key adherence messages to customers who might not sign up for a program.

Then again, even if we can do it, we may not want to deliver behavioral retargeting. After all, some patients have conditions that they’d rather keep private. They may not appreciate a reminder message from a pharma company that manifests as a banner ad on their favorite website. If this is the case, such issues can easily be addressed with a simple opt-out that prevents future retargeting from the ad server.

These days, behavioral retargeting is closely associated with advanced ecommerce websites. Looking forward, it will probably become another tool for communicating with patients and healthcare professionals. Before that happens, industry thought leaders need to think carefully about how patient health information is used and retargeted across different websites, channels, and platforms.

Questions? Comments? You can contact the author directly at blog@ochww.com.
Please allow 24 hours for response.

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Speed That Belies Size

The interwebs sparks all sorts of great stories. Cat videos are awesome. Only boutique agencies “get” digital. And big agencies are only good for bloat.

We can all agree on the first. The latter two—well, as “Mortal Kombat” used to kick off its matches: Fight! Which is not to say there aren’t odd days in the quagmire week where machinery gets in the way. But more often, the potential of having a great many top folk in one place is its own advantage.

Rapid response can be assembled in short order. Properly motivated and target-focused, this is a critical mass of strategy, planning, creative, coders, UX, and more that can more than handle itself in the ring. And as in all good moments of fission, that time to reaction can really cook.

Just this last week the mobile group put together a 2-day hackathon. Thirty or so pros, many meeting for the first time, split into 5 teams across an equal number of brands.

Two days to learn about multiple capabilities in a new software development kit (SDK) from a leading telecomm vendor; conjure that fresh knowledge into a mobile app concept; push pixels and punch words to fit an appropriate number of screens, menus and assets; and program it out into a working prototype that had to impress a showcase session at the end of the second day.

Every group delivered sit-up-and-take-notice work. The results were a wowza gathering of mobile goodness across luxury and consumer packaged goods, financial and communication services—and from our corner, healthcare adherence.

Building on the tools offered by the SDK, the Ogilvy CommonHealth Worldwide team concepted an app that tracks a person’s pattern of behavior, uses location to assess health-positive and health-negative activities, and then provides the right level/tone of support to make sure they’re properly managing their condition through treatment.

These weren’t blue sky exercises. They are real apps, based on real insights, and they will be leveraged for real next steps with their respective brands.

Not bad for 16 hours. And more common than “big agency” is often credited with. Edgy and current is critical to digital thinking. But that’s not the sole province of “small & scrappy.” Mass can equal more talent, more discipline, more expertise and experience to kick into gear and kick it up a notch. On your next journey into digital, consider all your options.

But whatever else—trust me on the cat vids.

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Mobile Health—Three Technology Challenges

Do you have an iPhone? Great, me too. Now, on the count of three, we’ll both drop our iPhones into a pail of water.

Ready? One, two… Wait, what’s the hesitation? I don’t see you taking the plunge with me.

And this underscores one of the big problems with our inevitable future with electronic health records (EHRs): our mobile devices just aren’t up to the task. In fact, if you stop and think about it, we’re really expecting an awful lot from these little technological marvels.

In addition to this shortcoming with hardware, there are potential problems with the EHR networks and the challenges of sharing secure data. Even if this is all addressed with regularly updated software, we still have to think about our creaky, inconsistent energy infrastructure.

I’m actually quite excited about EHRs, since they represent a leap forward in the way patients are diagnosed and treated. That’s why I hope there are serious efforts to address a few key challenges associated with the rapid uptake of EHRs.

Tough Mobile Devices

 The dare to drop your iPhone into water seems silly, but it highlights the inherent weakness of the device. Despite having a (relatively) tough exterior, the iPhone and most Android devices are not exactly waterproof.

We, as humans, are fairly water-resistant. It’s a nice design perk that allows us to swim, dash through the rain, and spill coffee on ourselves. (None of this is recommended with your iPhone.)

In many cases, we’re pretty tough on our bodies. From sports to everyday life, our bodies are pretty resilient. We get banged up, patched up, and do it all over again. Through much of this full-contact life, we’re carrying delicate computers, often wrapped in some kind of third-party case. It’s like Bubble Wrap around a china doll: bulky, unattractive, and definitely not part of the original design.

Our smartphones will become more powerful and more integrated into our health lives. From heart monitors to blood glucose tests, smartphones are becoming essential health devices.

Manufacturers will need to consider ways of making more durable devices, not just pretty things that run great in the lab. Someone’s life may literally depend on it.

Few manufacturers make tough smartphones, but hopefully more are on the way. We already have tough wristwatches, tough cameras, and some very tough cars. If we’re going to tote our health information on these devices, we’re going to need a device that actually works if you get injured around water.

That leads to the next issue to consider:

Proprietary EHR Format

Does anyone know what EHR my local hospital uses? If so, let me know—I’d like to install the right app on my smartphone.

Actually there are two regional hospitals. I sure hope that they use the exact same system, although I doubt it. Does that mean I need to download two apps and enter vital health information twice?

If you are injured and need access to your health records, you can quickly scroll through your apps and find what you need. But in a different scenario, you may be unable to work your password-protected device. What happens? How do medical professionals get to essential health information?

In an emergency, EMTs might check for a medical alert bracelet or necklace, but beyond that they’re going to be looking for your wallet. Yes, that low-tech leather thing in your pocket, which contains your driver’s license and health insurance card.

To my knowledge, there’s no universal health dock for emergency rooms and EMTs. They can’t just take your iPhone and access your personal health apps. Your mobile EHR is only useful if it is accessible.

Right now, we’re in a fragmented marketplace where there are lots of major solutions vying for the dominant position. Until we have an accepted standard that everyone adopts, we’re going to be living in a world where your wallet contains the most high-tech information about your health.

Which leads us to the third issue to consider…

Fragile Computing Cloud

People love to read scary fiction. Zombies and vampires stories are more popular than ever.

Know what’s really scary? Try reading the book One Second After by William R. Forstchen. It’s a book that paints a terrifyingly realistic world after an electromagnetic pulse.

In the book, the US is hit by a terrorist attack that leaves us without electricity. We are more reliant on electricity than we realize, and the story details our decline into chaos and anarchy.

In the past, doctors could work with handwritten patient records if the electricity failed. But as we all know, many of those records are moving into the cloud.

While many experts debate the security of the cloud, few are talking about the very basic challenge of electricity. With no power, there’s no way to download patient records. And with no physical backup, doctors may find themselves with precious little information about the patients they need to treat. Even if a hospital has generators as backup, that still doesn’t solve the problem of Internet access if the rest of the grid is incapacitated.

Doctors and pharmacists use electronic devices for dosing, contraindications, and diagnosis. Knocking out the power grid or disabling one of these clouds could have a devastating effect on the way a doctor treats a patient.

The Good News

There is good news in all of this. Smart entrepreneurs undoubtedly see these opportunities as well.

Over the past few years, we’ve seen a massive growth in tough cameras. If these cameras continue to be popular, manufacturers may see a market for more durable smartphones. They are missing some profit opportunities, which are being addressed by aftermarket cases.

And with EHRs becoming part of modern medicine, we’ll begin to see some synergy between professional and patient apps. As an industry, we’ve done a pretty good job with application programming interfaces (APIs) that allow for secure connections. It would make sense to bridge the gap between personal health records on a smartphone and hospital computer systems. Information about your health conditions, allergies, and current treatments could help save your life.

The big challenge may be something that happens at a government level. The average citizen has no influence over the security and backup of our electricity grid. We also have no real input about how much of our information will be migrated digitally to the cloud. These are questions that are answered by government and utility companies. This can be good or bad news, depending on how you frame the challenge.

Looking forward, there are good reasons to be excited about mobile health. Our devices are becoming more powerful, the software is smarter, and the EHRs are poised to make a positive impact on healthcare.

Just don’t drop your smartphone in water and everything will be fine.

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The Ultimate Health App Road Test

As someone with a self-confessed addictive personality, I am a fully paid-up app junkie.

MobiHealthNews’ latest report, Consumer Health Apps for Apple’s iPhone, predicts that by summer this year there will be over 13,000 consumer health apps. Indeed, a casual glance through the Apple Store reveals countless apps to help you quit smoking, improve your diet, gain a six pack and better your running technique.

But amidst the countless options available, what are the ingredients required to make a useful, effective health app? Are the most successful apps of the moment underpinned by genuine medical and scientific thought? In our industry, we are finding that clients are becoming increasingly fascinated with apps, and it is becoming more and more important to ask ourselves these questions.

As someone with a self-confessed addictive personality, I am a fully paid-up app junkie. I have apps for everything: apps that tell me when the next bus arrives so I don’t have to wait for longer than two minutes in the rain; apps that allow me to listen to the entire Spice Girls back catalogue without needing to purchase a single song; apps that convert my appalling photography into masterworks that Annie Leibovitz would be proud to call her own. I’ve been known to wake early in the morning and claw at my iPhone with feverish impatience, desperate to find out if Suliman23 has correctly identified the sketch of a meerkat I scribbled badly the night before. I have bought books, clothes, maps, games, even kitchenware via smartphone apps. Some would call it an obsession.

For better or worse, apps have changed the way I live my life. They have made travel, for example, much more efficient. I can use apps to find a restaurant in an unfamiliar part of town and hail a taxi home when one of my other apps tells me the train line is down.

But apps have also provided an unwelcome avenue of procrastination. If, as a young boy, I had known my adult self would spend hours catapulting virtual birds at small clusters of hideous green pigs, I would have been aghast. Apps can have a stultifying effect on your creative consciousness, robbing your imagination of thinking time by enslaving you into hours of Luddite poking and clawing.  Why read Proust when you can spend half a day trying to slice a rhombus into six equal parts?

It is for this reason that I want to stop using apps to waste time, and see if I can use them to make positive changes to my lifestyle. As someone who prefers the sofa to the gym, who could cut down on eating and drinking, and should definitely quit smoking, it’s about time I started looking after myself.  Over the next few weeks I am going to road test a variety of consumer health-related apps to see if they really have the transformative power they claim; and ultimately to see if they make me a fitter, healthier and happier person. I’ll be looking to identify what makes a health app effective as well as investigating the companies that make them and their expertise in the field. I’ll be providing blog updates along the way, so please watch this space.

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Affordability of Medicines—the New Kid on the Block

You know the feeling: you pop into the shop and see something you want to buy, but times are tight and you simply can’t afford it. You want the best, but you feel compelled to consider all your spending priorities and choose to go for the less expensive brand—it’s a question of affordability.

In today’s environment, this is a challenge facing healthcare systems throughout the world. Coupled with this, more healthcare resources are being consumed as people are living longer with increasingly complex health problems. Add to this the increased complexity of how national health systems are assessing a medicine’s value, and you have the perfect storm.

Indeed, just as you weigh up whether you can afford to pay for something, those who pay for medicines (termed “payers”) all have affordability at the forefront of their minds. Governments are addressing the issue by driving further healthcare reforms, while payers are aggressively managing costs, limiting therapy choice, and shifting more of the cost burden to consumers.

However, if industry is to effectively support payers in their informed decision-making, it is important that they are viewed as investors in their community’s health and not simply gatekeepers of the budget.

As investors in health, payers deploy a variety of instruments to support medicines’ cost control. These can be broadly divided into supply-side and demand-side approaches.

Demand-side instruments include:

  • National-level price negotiations/price cuts
  • Reference pricing systems–using the cost of other similar drugs to set the price
  • Health technology assessments–assessing the value of a medicine using a range of tools including cost- and comparative-effectiveness
  • Promoting generic medicines and parallel imports–parallel imports refer to the practice of importing a medicine from another market where the medicine is cheaper

Supply-side instruments include:

  • Patient co-payments–this is the practice where patients will pay a certain percentage of the medicine’s cost
  • Reimbursement restrictions–restricting the money paid for a particular drug
  • Delisting–removing a product from a list of drugs that will be paid for
  • Prescribing budgets–setting financial budgets for the prescribing of medicines
  • Formularies and guidelines–a list of medicines that have been approved to be prescribed, or their incorporation within guidelines that should be adhered to

To date, the pharmaceutical industry has focused predominantly on communicating about cost and cost-effectiveness to secure optimal pricing and reimbursement for their brands at a market level. Arguably, more needs to be done to demonstrate the true benefit of treatment to patients, the communities in which they live, and society at large.

Some solutions to help demonstrate the true value of a treatment include:

  • Evaluating and demonstrating the longer-term patient outcomes
  • Demonstrating and communicating the economic value across all stages of a product lifecycle
  • Supporting payers to identify which patient segments would benefit most from treatment
  • Relating the outcomes demonstrated through clinical trials to local demographics

There is no doubt that the industry continues to go through a challenging time, while the economic crisis faced by many countries is only likely to get worse. In this environment, the issue of affordability is higher up on governments’ and payers’ agendas. However, by understanding and meeting the needs of payers and their communities, the industry will be better placed to ensure patient access to their medicines.



Also posted in Access, Clients, clinical trials, Efficacy, Health & Wellness, Healthcare Communications, Managed Care, Marketing, medical affairs, Reimbursement | Tagged , , , , , , , , | Comments closed

A “Credit Score” for Medication Adherence?

In June of 2011, FICO—originator of the credit score in 1956—introduced a medication adherence score model that predicts patient adherence to prescription medications. Approximately 3 million Americans were to have an adherence score by the end of 2011 and an additional 10 million are expected to have one by 2012.  If proven a predictor of adherence, this new score has the potential to revolutionize prescription drug marketing and may have sweeping implications for the insurance industry.

Most Americans are familiar with credit scores—often referred to as FICO scores. The FICO scoring system was created by Fair Isaac and Company and is used to predict the likelihood of a consumer to repay a loan. The lower the FICO score of the consumer, the greater the risk of default to the lender.

Years ago FICO scores became a key tool for banks and financial institutions in marketing credit cards and loans. What quickly became apparent was that the consumers with the lowest scores were generally the most responsive to credit offers.

The FICO score revolutionized credit by enabling lenders to reach a balance between risk and an acceptable cost to acquire new customers. The score eliminates the time and expense of marketing to potentially inappropriate consumers or to those unlikely to respond. It also short-cut the amount of information needed for lending decisions, spawning “instant credit” and rapid approval of auto loans. In a similar way, a medication adherence score could alert a healthcare provider immediately if a patient is at risk of being nonadherent, so appropriate steps to improve their adherence can start early.

Medication adherence is a major issue for patients, employers, managed care and pharmaceutical companies and is a multibillion-dollar problem in the US. A score that predicts medication adherence can help pharmaceutical companies in two key ways:

  • For brands with medication adherence programs, they can target the programs to patients who actually need help with medication to more efficiently produce better healthcare outcomes
  • New patients can be acquired who are more likely to be adherent to medications

This is all good. But where banks and financial institutions found that the FICO credit score became a predictor of responsiveness to direct marketing, it is not yet known if the medication adherence score will have a similar predictive quality with respect to direct marketing. It is also to be determined whether a medication adherence program delivered to patients who have a score is more effective at increasing medication adherence vs. traditional programs delivered to patients without a score.

In managed care, there is continual pressure to make patients more accountable for their health and well-being, and the adherence score has the potential to stratify insurance pricing based on adherence. It could be used to exclude patients from coverage much like credit scores are used in underwriting property and casualty insurance, and also has the potential to impact how life insurance is underwritten.

Early adopters will be the first organizations to start reaping the benefits of medication adherence scores to improve patient healthcare outcomes and strengthen their brands. When it comes to medication adherence scores, is your company making things happen or watching what happens?

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